First Author: K.Fotis UK
Co Author(s): H. Eleftheriadis 0 0 0 0 0 0 0 0 0
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To report the visual and optical coherence tomography (OCT) outcome of peripapillary idiopathic polypoidal choroidal vasculopathy (IPCV) treated with focal laser photocoagulation with the PASCAL laser.
King’s College Hospital NHS Foundation Trust, Department of Ophthalmology, Denmark Hill, London, UK
Retrospective study of patients diagnosed with peripapillary idiopathic polypoidal choroidal vasculopathy (IPCV), confirmed on indocyanine green (ICG) angiography and treated with focal laser photocoagulation with the PASCAL laser, with or without concomitant use of intravitreal injections of ranibizumab. All patients had reduced vision due to foveal involvement with intraretinal or/and subretinal fluid. Patients with other retinal conditions or these who received any treatment for peripapillary IPCV were excluded from this study.
Twelve eyes (6 right eyes) of 12 patients (9 female) of mean age 74.3±11 years with peripapillary IPCV, confirmed by ICG angiography, treated with focal laser photocoagulation between 2009 and 2013, were included in this study. Mean best corrected vision improved from 67±17 EDTRS letters prior to laser to 72.2±8 at the last follow up 18±12 months after the laser treatment, although this difference was not statistically significant (p=0.35). Mean central subfield thickness was reduced from 361±97 microns before treatment to 246±77 (p=0.006) at the last follow up. Moreover all patients apart from one had dry maculae on OCT at their last assessment. Five patients (42%) needed a second session of focal laser treatment and three patients (25%) received additional treatment with intravitreal injections of ranibizumab (3, 4 and 19 injections respectively) following the laser photocoagulation. None of the patients developed any serious adverse events following treatment.
Treatment of peripapillary IPCV with focal laser photocoagulation with the PASCAL laser resulted in improved anatomical and visual outcomes in the vast majority of treated eyes. A small number of patients may require adjunctive therapy with intravitreal injections of ranibizumab. In the anti-VEGF era, the use of a cheaper treatment modality like focal laser with specific indication the peripapillary IPCV is a realistic and effective option.